Cognitive and symptomatic predictors of functional disability in schizophrenia

Abstract

Background: Neurocognition and negative symptoms play a major role in predicting functional outcomes in patients with schizophrenia. Few studies have assessed the relationship between functional outcomes and the MATRICS consensus cognition battery (MCCB), which will be central to future clinical trials of cognitive enhancing agents.

Aims: To assess the role of individual MCCB domains on functional outcomes.

Method: 185 stable outpatients with schizophrenia were enrolled and assessed with the MCCB, Social Adjustment Scale-II (SAS-II) and Multidimensional Scale for Independent Functioning (MSIF), along with BPRS and SANS.

Results: We found significant relationships between MCCB neurocognitive domain scores, negative symptoms and aspects of functional outcome in schizophrenia. Specifically, we found that work/education functioning is predicted by working memory performance and negative symptoms; residential status (independent living) is predicted by verbal memory scores; and social functioning is predicted by social cognition, attention and negative symptoms. We also found that negative symptom severity was not related to residential status, even though it demonstrated the predicted associations to work and social functioning.

Conclusion: To our knowledge, this is the first study to assess cognition and functional outcomes using MCCB, SAS II and MSIF. Our results extend prior work and help provide more data on the relationships between cognition, symptoms and functional outcome using "real world" measures.

Conflict of interest statement

Conflicts of Interest: Syed Shamsi, MD—no conflicts of interest.

Adam Lau, MD—no conflicts of interest.

Todd Lencz, PhD—Dr. Lencz has received consulting fees and/or honoraria from Eli Lilly, Merck, Clinical Data Inc., GoldenHelix, Inc., Guide-point Global, and Cowen & Co.

Katherine E. Burdick, PhD—no conflicts of interest.

Pamela DeRosse, PhD—no conflicts of interest.

Jean-Pierre Lindenmayer, MD - Dr. Lindenmayer has received grant support from Astra Zeneca; Otsuka; Pfizer; Dainippon Sumitomo; Azur; Janssen; Lilly; NIMH and has performed consultancy for Lilly; Janssen.

Ronald Brenner, MD—no conflicts of interest.

Anil K. Malhotra, MD—no conflicts of interest.

Copyright © 2010. Published by Elsevier B.V.

Figures

Fig. 1

Mean scores and 95% confidence intervals of individual cognitive domains.